Snoring is the sound of obstructed breathing during sleep in which the soft tissues at the back of the throat lose muscle tone, flop back and vibrate. Snoring disrupts the quality of sleep often resulting in excessive daytime sleepiness. Snoring can also disturb the sleep of those nearby, causing great frustration and placing a strain on relationships. Snoring and sleepiness affect over 40% of the adult population, often causing significant health and quality of life problems. While snoring can be harmless (benign snoring), it can also be the sign of a more serious medical condition which progresses from upper airway resistance syndrome (UARS) to obstructive sleep apnea (OSA). OSA is a serious medical condition which can lead to hypertension, heart disease, stroke and diabetes.
When you breathe normally, air passes through the nose and past the flexible structures in the back of the throat such as the soft palate, uvula and tongue. Whilst you are awake muscles hold the airway open. When you fall asleep these muscles relax but normally the airway stays open. Snoring indicates that there is an obstruction to the airway.
What is Sleep Apnea?
About 70% of people who regularly snore also have obstructive sleep apnea (OSA) in which the soft tissues in the throat, including the tongue, collapse and are sucked against the back of the throat. This blocks the upper airway and air flow stops, or is greatly reduced. When the blood oxygen level becomes low enough the brain sends a signal known as an arousal and the sleeper partially awakens, the obstruction in the throat clears and the flow of air starts again, usually with a gasp. Most people are not aware this is occurring.
The classic picture of OSA includes episodes of snoring that begin soon after falling asleep. The snoring proceeds at a regular pace for a period of time, often becoming louder, and for some people is interrupted by a long silent period during which little or no breathing is taking place (apnea). The apnea is then interrupted by a loud snort and gasp and the snoring returns to its regular pace. This behaviour recurs frequently throughout the night.
Cycles of apnea â€“ obstruction and breathing â€“ can occur many times per hour during sleep and stops people getting into the deeper stages of sleep which are important for well being.
Apnea sleeping patterns are associated with spikes in release of adrenaline which have an impact on the cardiovascular system and over time can lead to elevated blood pressure, heart disease, stroke, diabetes and excessive daytime sleepiness as well as impacting on quality of life.
The condition known as upper airway resistance syndrome (UARS) lies midway between benign snoring and true obstructive sleep apnea. People with UARS suffer many of the symptoms of obstructive sleep apnea but sleep testing will be negative. The good news is that sleep apnea and upper airway resistance syndrome can be treated easily and effectively with either an oral appliance or a CPAP machine.
Sleep Apnea Symptoms
It is important to emphasise that often the person who has obstructive sleep apnea does not remember the episodes of apnea and wakening during the night. The predominant symptoms are usually associated with excessive daytime sleepiness due to poor quality sleep during the night. Sometimes family members, especially spouses, witness the gasping, pauses or disturbances in breathing.
Symptoms that may be observed and experienced can include any of the following:
- Loud snoring
- Disturbances in breathing
- Pauses in breathing (apnea)
- Waking unrefreshed in the morning
- Excessive daytime sleepiness
- Morning headaches
- Recent weight gain
- Limited attention
- Memory loss
- Depression and mood changes
- Poor judgement
- Personality changes
- Sexual dysfunction
If your partner shows any of the above symptoms, you should encourage them to have an assessment. Proper treatment will provide a significant improvement in your partnerâ€™s health and wellbeing and will no doubt improve your sleep as well.
Complications of Sleep Apnea
- Heart disease
- Abnormal heart rhythm (arrhythmia)